| NPI | 1245090646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER DAUGHERTY Manager 971-453-3430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-05-03 |